Idaho Supreme Court upholds Medicaid expansion initiative, dismissing legal challenges
On Tuesday, the Idaho Supreme Court voted to uphold Proposition 2, dismissing legal challenges to an initiative that was approved by voters in November 2018.
Proposition 2 expanded Medicaid eligibility in Idaho to those under 65 years old whose income is at or below 133 percent of the federal poverty level, and who are not eligible for other state insurance coverage. Under the Affordable Care Act, however, 5 percent of income can be excluded when calculating Medicaid eligibility, which means that the measure increased the income threshold to 138 percent of the federal poverty level. Proposition 2 was approved last year by a vote of 61 percent to 39 percent.
On November 21, 2018, Brent Regan, head of the Idaho Freedom Foundation’s board of directors, filed a lawsuit in the Idaho Supreme Court seeking to block Proposition 2. The lawsuit stated, "In essence, Proposition 2 has delegated to the federal government for its future determination Idaho’s percentage of financial contribution and therefore Idaho’s share of the costs Idaho will be forced to pay for Medicaid expansion."
Chief Justice Roger Burdick, writing for the 3-2 majority in dismissing the lawsuit, wrote, "If we were to accept Regan’s argument that any reference to a federal statute delegates lawmaking authority to the federal government, then many of Idaho’s statutes would be unconstitutional, and in fact, the option of any cooperative federal-state program would be curtailed." Justices of the Idaho Supreme Court are elected in nonpartisan elections, but four of the court’s five members were appointed by Republican governors prior to standing for election.
As of November 2018, a total of 36 states and Washington, D.C., had expanded or voted to expand Medicaid, while 14 states had not. Medicaid expansion initiatives were on the ballot in four states in November 2018. It was approved in three: Idaho, Nebraska, and Utah, and defeated in Montana. The first ever citizen initiative to expand Medicaid coverage under the Affordable Care Act was approved in Maine in 2017.
Legislation was introduced in both the Idaho and Utah 2019 legislative sessions to amend or repeal the Medicaid expansion initiatives.

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